51 yo just diagnosed with Osteoporosis

@stacibw, I'm sorry you are a new member in this club that no one wants to join. It's a confusing diagnosis and there is so much information out there, much of it conflicting. IMO, the first step is to try to determine the root cause. In your case, it is undoubtedly the early menopause (loss of estrogen), but make sure your doctor does a 24 hour urine test (and other blood tests) to see if anything else is off (like too much or not enough calcium in your urine, parathyroid function, medications like corticosteroids, etc.). You have time to think even though your MD called this "aggressive" so I'd encourage you to research before you start a medication so you can feel as confident as you can about what is best for you - there are SO many considerations for each. It sounds like you will need a bone builder like Forteo, Evenity or Tymlos. You might also inquire about HRT since you are young and only a few years post menopause. Many of us have had to learn to be our own advocates and, at this point, I seem to know more than the MDs I've seen. Find a good endocrinologist or rheumatologist. You will also need to investigate diet and safe ways to exercise. I have learned so much on this site and also from watching particular YouTube videos. I really like OsteoBoston (here is just one example of a specialist who presented, but there are MANY) https://www.youtube.com/watch?v=zG_V6XPIDFU&t=751s. Others will weigh - this is marvelous forum and you are at the tip of the iceberg. Wishing you the best.

Here is an article about blood tests that can identify other possible underlying conditions:
https://www.medicalnewstoday.com/articles/blood-test-for-osteoporosis

hi stacybw,
you are starting at the best place. We have a lot of variant opinions and loads of experience. And we've all been exactly where you are. It is best to challenge everything you read and respond with questions that we'll love to answer. My opinion:
Mostly of us want to combat this naturally. You can't make up for five years of low estrogen, hence five years of bone loss without medication. Very luckily there are two amazing medications--Tymlos and Forteo.
The medication divided by the way they work are called antiresorptive and anabolic. The drugs your PCP mentions are all antireorptive. They preserve older bone and while they do prevent fracture, they halt the renewal process that resolves fissures and they reduce the the blood supply within the bone.
The drugs that stimulate new bone growth are Tymlos, Forteo and Evenity. Evenity stimulates new bone growth in the first few months and then becomes antiresorptive. It is a newer drug with boxed warnings about cardiac issues.
They say that once you begin osteoporosis medications, you can never stop. I hold this concept as true.
We take medications to prevent fracture.
I've been on Forteo for almost a year. I haven't had side effects.
I know what I'd do in your situation because this is what I did.
Do the research.
Ask your doctor (I like her flexibility) for bone markers. P1NP and CTX before you begin medication.
Take Forteo.
Get bone markers initially and every three months.
Watch this video https://www.youtube.com/watch?v=Cd0YT-OV97c
And keep your questions coming this way.

I would do some research before going on any medication. Do you see an endocrinologist? Primary care doctors tend to prescribe bisphosphonates or Prolia first but as you will see, it is better to start with a bone builder- unless your osteoporosis is mild. If very mild/borderline you might even try a more holistic approach, at first.

Bone density, in my experience, dropped precipitously in the first year of menopause but then the drop eased up. It still dropped but wasn't as "aggressive" (to use the term your doctor used).

Bone builders are Tymlos Forteo and Evenity (first 6 months for Evenity) . Anti-resorptives (that increase bone density by affecting turnover) are Prolia and bisphosphonates like alendronate (Fosamax) or IV Reclast, and the last 6 months of Evenity. Insurance like the cheaper anti-resorptives but it is well known they affect the effectiveness of bone builders if needed eventually, though they are still useful regardless.

Resources that people here have mentioned:

Keith McCormick (chiropractor and osteoporosis expert)
"A Whole Body Approach to Osteoporosis" (book)
"Great Bones" (more recent, very comprehensive 700 pg book that includes "whole body approaches" and medications

Dr. Ben Leder, MGH endocrinologist
YouTube video "Combination and Sequential Approaches to Osteoporosis Treatment"

Lanie Simpson (website, master classes)
Margaret Martin (exercises, book, website, classes) melioguide. com

ps I did Tymlos, and am following it with Evenity (noone else in my doctor's practice did this) and then will do Reclast. I do reduced dosage of everything because I am sensitive to meds, though I worked up to almost full dose Tymlos and am going to try a full dose of Evenity after doing full dose then two months of 1/2 dose!

@gently, cool video - so interesting - thanks for posting! There is a lot of information there that I've never heard before (e.g., soy isoflavones with green kiwi). I feel like we are on the brink of new possibilities for treatment.

I have been on hormone replacement therapy for one year.

Thank you for all of this info.

Why do I need a rheumatologist or an endocrinologist?

If you went on hormone replacement before your estrogen levels dropped with menopause, then you might need to look into secondary causes besides hormonal changes. Do you take Vitamin D3, and do you know your levels? Is your parathyroid okay? Do you take steroids? Etc. I don't know much about hormonal replacement and how effective it is at addressing bone loss at menopause but maybe others can chime in.

The PCP's I know do not know enough about osteoporosis, to be frank. You can research endocrinologists and find one who specializes in or treats a lot of people with osteoporosis. Endos can also check those secondary causes.

It has been worth it for many of us to take our time. You can also do a consult with Keith McCormick in person or by phone.

They are the docs who specialize in OP. By the way, it has taken me months to get an appointment with either.

Cancellation lists sometimes help. I call at 10 am when people have cancelled 🙂

Even if I further down the list they tend to give me the cancelled appointment. Saves them the trouble of calling people!

Also sometimes a PCP referral can speed things up. @babs20 sorry you had to wait so long!

I'm on cancellations lists all over the city and I'm not exaggerating, but I have NOT called at 10. Such a great suggestion. Thanks, @windyshores. 🙂